November 2009


Research Highlights
Other Cessation News


Research Highlights

Other Cessation News




CDC Survey Finds Adult Smoking Declines Have Stalled

According to a new report from the US Centers for Disease Control and Prevention (CDC), the number of Americans who smoke hasn't changed over the last five years and actually rose slightly from 2007 to 2008. It is clear from the recent stall in progress that more must be done to implement evidence-based prevention and cessation strategies.

Over the longer term, smoking rates have declined since 1998 from 24.1 to 20.6 percent. However, the report notes that "during the past five years, rates have shown virtually no change." In fact the percentage of Americans who smoke has begun to increase again, rising from 19.8 percent in 2007 to 20.6 percent in 2008. While the CDC said this increase was not statistically significant, it is the first increase in the adult smoking rate since 1994.

Following last month’s troubling reports from the Institute of Medicine and the American Association of Pediatricians on secondhand smoke, this report comes at a critical time as November marks both Lung Cancer Awareness Month and the Great American Smoke Out.

The CDC and other experts have cited several factors for the stall in recent years, including deep discounts used by tobacco companies to offset tax increases, significant increases in overall tobacco marketing and cuts to state tobacco prevention and cessation programs.

The CDC investigators place much of the blame for the turnaround in smoking rates on recent cutbacks in funding for state tobacco-control programs, which had proven successful. According to the report, from 2000 to 2009 states received $203.5 billion in tobacco-related revenue. However, less than 3 percent of the funds have been earmarked for tobacco prevention and cessation programs in the states. The researchers added that if states were to use just 15 percent of the money they receive from tobacco, they could adequately fund tobacco-control measures at CDC-recommended levels.

According to Campaign for Tobacco-Free Kids, there is much more that can be done at all levels of government to increase prevention and cessation efforts:

  • The pending health care reform legislation presents Congress with an immediate opportunity for action. It is vital that health care reform include funding for community-based prevention initiatives, including tobacco prevention and cessation. Congress should also require that private and public insurance plans, including Medicaid, cover tobacco cessation services for all beneficiaries. The House-passed health care reform bill achieves these goals, and the Senate bill should as well.
  • States must increase their efforts to implement proven strategies to reduce tobacco use, including higher tobacco taxes, smoke-free workplace laws and adequately-funded tobacco prevention and cessation programs. Most states have underfunded their tobacco prevention programs, and in the past year, many have cut them substantially due to fiscal crises. Rather than take these backward steps, states should hike tobacco taxes to help fill budget gaps and use some of the revenue to fund tobacco prevention and cessation programs.

The Federal government has taken major strides this year by approving a 62-cent increase in the federal cigarette tax and enacting the new law granting the US Food and Drug Administration (FDA) authority to regulate tobacco products and marketing. The 2008 data released in this report does not reflect the impact of the federal cigarette tax increase, but there is evidence that the increase has already had a significant impact. Cigarette manufacturers reported a 10 percent decline in cigarette sales in the third quarter of this year, and calls by smokers to smoking cessation quitlines increased dramatically following the tax increase.

According to the report, from 2007 to 2008 the number of Americans who smoked remained constant, at about 46 million. Smokers were more likely to be male (23.1 percent) than female (18.3 percent). The majority of smokers are people who did not graduate from high school, and the lowest rates are among those with a college graduate degree, the report found. Asian Americans had the lowest smoking rates (9.9 percent), and American Indians and Alaskan Natives had the highest (32.4 percent), the researchers found.

The CDC report, published in the November 13, 2009, issue of the CDC Journal Morbidity and Mortality Weekly Report, can be found at

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Research Highlights

Exposure To Tobacco And Lead Linked To ADHD In Children

Researchers in the US found that exposure to tobacco in the womb and to lead during childhood was linked to a particularly high risk for Attention-Deficit/Hyperactivity Disorder (ADHD) in children, suggesting that while we tend to focus on treatment for ADHD, eliminating such exposures might prevent the condition in many hundreds of thousands of children.

The study was the work of senior author Dr. Robert Kahn, a physician and researcher at Cincinnati Children's Hospital Medical Center, Ohio, and colleagues, and was published online on 23 November in the journal Pediatrics.

Kahn and colleagues estimated that up to 35 percent of cases of ADHD in youngsters aged between 8 and 15 could be reduced by getting rid of both prenatal exposure to tobacco and childhood exposure to lead: in numbers this figure represents some 800,000 children in the US population.

Kahn told the press that while the tendency was to focus on treatment:

"Our study suggests that reducing exposures to environmental toxicants might be an important way to lower rates of ADHD."

For the study, which was funded by grants from the National Institutes of Health and the Academic Pediatrics Association, and a Robert Wood Johnson Generalist Physician Faculty Scholars Award, Kahn and colleagues used data on 2,588 youngsters aged 8 to 15 who had taken part between 2001 and 2004 in the National Health and Nutrition Examination Survey (NHANES).

NHANES is a cross-sectional, nationally representative sample of the population of the US and includes information about health and diet. The survey is administered by the National Center for Health Statistics at the Centers for Disease Control and Prevention (CDC).

To assess prenatal exposure to tobacco, the researchers used mothers' reports on cigarette use during pregnancy. To assess lead exposure, the researchers used current blood lead levels, and the diagnosis for ADHD was based on the Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition, considered the "gold standard" for defining certain mental health conditions.

The results showed that:

  • 8.7 percent of the children met the diagnostic criteria for ADHD
  • Children exposed prenatally to tobacco smoke were 2.4 times more likely to have ADHD
  • Children whose blood levels were in the top third (upper tertile) for lead were 2.3 times more likely to have ADHD
  • Children with both prenatal tobacco exposure and in the top third for blood lead levels were 8.1 times more likely to have ADHD compared to children with neither exposures
  • The increased risk of ADHD from both types of exposure was even greater than expected by multiplying the independent risks

The authors concluded that:

"Prenatal tobacco and childhood lead exposures are associated with ADHD in US children, especially among those with both exposures."

They suggested that reducing exposure to tobacco in the womb and lead in childhood may be important ways to prevent ADHD.

Lead author Dr Tanya Froehlich, a physician in the Division of Developmental and Behavioral Pediatrics at Cincinnati Children's said:

"Tobacco and lead exposure each have their own important adverse effect."

"But if children are exposed to both lead and prenatal tobacco, the combined effect is synergistic," she explained.

For more information, see web link:
Medical News Today November 23, 2009


Study Raises Concerns about Outdoor Second-Hand Smoke

Indoor smoking bans have forced smokers at bars and restaurants onto outdoor patios, but a new University of Georgia study in collaboration with the Centers for Disease Control and Prevention suggests that these outdoor smoking areas might be creating a new health hazard.

The study, thought to be the first to assess levels of a nicotine byproduct known as cotinine in nonsmokers exposed to second-hand smoke outdoors, found levels up to 162 percent greater than in the control group. The results appear in the November issue of the Journal of Occupational and Environmental Hygiene.

"Indoor smoking bans have helped to create more of these outdoor environments where people are exposed to secondhand smoke," said study co-author Luke Naeher, associate professor in the UGA College of Public Health. "We know from our previous study that there are measurable airborne levels of secondhand smoke in these environments, and we know from this study that we can measure internal exposure.

"Secondhand smoke contains several known carcinogens and the current thinking is that there is no safe level of exposure," he added. "So the levels that we are seeing are a potential public health issue."

Athens-Clarke County, Ga., enacted an indoor smoking ban in 2005, providing Naeher and his colleagues and ideal environment for their study. The team recruited 20 non-smoking adults and placed them in one of three environments: outside bars, outside restaurants and, for the control group, outside the UGA main library. Immediately before and after the six-hour study period, the volunteers gave a saliva sample that was tested for levels of cotinine, a byproduct of nicotine and a commonly used marker of tobacco exposure.

The team found an average increase in cotinine of 162 percent for the volunteers stationed at outdoor seating and standing areas at bars, a 102 percent increase for those outside of restaurants and a 16 percent increase for the control group near the library.

Naeher acknowledges that an exposure of six-hours is greater than what an average patron would experience but said that employees can be exposed for even longer periods.

"Anyone who works in that environment—waitresses, waiters or bouncers—may be there for up to six hours or longer," Naeher said. "Across the country, a large number of people are occupationally exposed to second-hand smoke in this way."

Studies that measured health outcomes following indoor smoking bans have credited the bans with lowering rates of heart attacks and respiratory illness, but Naeher said that the health impacts of outdoor second-hand smoke are still unknown.

In Naeher's study, cotinine levels in the volunteers at the bar setting saw their levels increase from an average pre-exposure level of 0.069 ng/ml (nanograms per milliliter) to an average post-exposure level of 0.182 ng/ml. The maximum value observed, however, was 0.959 ng/ml. To put that number into context, a widely cited study has determined that an average cotinine level of 0.4 ng/ml increases lung cancer deaths by 1 for every 1,000 people and increases heart disease deaths by 1 for every 100 people.

For more information, see web link:
EurekAlert November 18, 2009


Toddlers, Obese Kids Suffer Most From Smoke

Secondhand smoke harms the cardiovascular health of children, especially toddlers and obese youngsters, researchers say.

Their study of 52 toddlers (aged 2 to 5) and 107 adolescents (aged 9 to 18) found an association between the amount of secondhand smoke exposure and a marker of vascular injury in toddlers. This link was two times greater in obese toddlers, the study authors noted.

Toddlers exposed to secondhand smoke showed a 30 percent reduction in circulating vascular endothelial progenitor cells, which are cells that are involved in the repair and maintenance of blood vessels.

The researchers also found that obese adolescents exposed to secondhand smoke had twice the evidence of vascular injury compared to normal-weight adolescents.

Despite having similar reported home settings, toddlers were four times more likely than adolescents to be exposed to secondhand smoke, the study authors added.

The cardiovascular changes seen in children exposed to secondhand smoke "are similar to changes that are well-recognized risks for heart disease in adults. This suggests that some aspects of adult heart disease may be initiated in early childhood, where prevention strategies may have great long-term impact," study senior co-author John Anthony Bauer, a principal investigator at Nationwide Children's Hospital & Research Institute at Ohio State University in Columbus, said in a news release from the American Heart Association.

"Our findings add to the importance of eliminating smoking and related exposures, especially for children, and obese children may need to be even more protected from these exposures," he said.

The study was scheduled to be presented Nov. 18 at the American Heart Association's annual meeting in Orlando, Fla.

For more information, see web link:
US News & World Report November 18, 2009


Internet Bridges Gap for Rural Residents who Need Anti-Smoking Programs

The Internet may soon join nicotine chewing gum, the patch and behavioral counseling as a remedy for tobacco addiction, says a University of Florida researcher who participated in a study of rural residents using their computers to kick the habit.

Remote residents were chosen as subjects because they live far from clinical services that have helped many of their urban counterparts to quit smoking, said Jesse Dallery, a UF psychologist and one of the study’s authors.

“People who live away from cities face special challenges in kicking the habit because they are served by fewer clinics offering smoking cessation programs and they usually lack public transportation,” he said. “Capitalizing on the reach of the Internet is one way to help these otherwise inaccessible smokers.”

People who tried the virtual program were able to refrain from smoking at more than twice the rate of another group who did not use it over an initial six-week period, although abstinence levels for both groups later dropped, Dallery said. The study, led by researchers in Kentucky, is published in the November issue of the journal Drug and Alcohol Dependence.

“We have developed an innovative, novel and effective abstinence-based behavioral therapy where smokers are routinely monitored using the Internet,” he said. “To the best of our knowledge, this is the first randomized controlled study to demonstrate that participating in an abstinence-based program over the Internet can help people to stop smoking.”

Cigarette smoking is most prevalent in rural areas, where it increased to 30 percent in 2006 from 23 percent in 2005, Dallery said. In rural Appalachia, where the study was done, smoking rates were as high as 34 percent in 2007, compared with 20 percent for the United States as a whole, he said. Statistics released by the US Centers for Disease Control and Prevention for 2008 show that cigarette smoking rose slightly for the first time in nearly 15 years to a little under 21 percent.

“Because people who live in rural areas smoke at disproportionate rates and have difficulty getting access to health care, their rates of disease are much higher,” Dallery said. Among the highest incidences of cancer, cardiovascular disease and other smoking-related illnesses are recorded in rural Appalachia, he said.

The study compared two groups of rural Appalachian Kentucky residents who participated in a smoking cessation program. Both received counseling and medical information about the hazards of smoking, but only one group was randomly assigned to an Internet-based monitoring system that targeted reductions in their carbon monoxide levels throughout the testing period.

A carbon monoxide monitor and Web camera was attached to each participant’s personal computer, and participants logged on to a Web site to provide carbon monoxide samples and receive immediate feedback, he said.

“The intervention is ideal for rural residents because it minimizes the need for twice daily visits to a clinic to collect breath samples that traditional abstinence programs require, and participants need only have a computer with Internet access,” he said.

Although fewer rural residents have access to the Internet than their city counterparts, that gap is narrowing with the increase of global Internet access by more than 300 percent between 2000 and 2008, Dallery said. Kentucky, a largely rural state, leads the nation in broadband expansion, he said.

The 35 smokers who participated in the Internet-based program were much more likely to have abstained at the end of each week of the initial six-week monitoring period than the 33 smokers who received only counseling and medical information, the study found.

At the end of the first week, 30 percent of the Internet group had been smoke free compared with 18 percent of the control group, and by the end of the sixth week the gap had widened to 34 percent and 13 percent, he said.

Over a 12-week period, however, abstinence levels dropped to about 5 percent for Internet users and to zero percent for the control group, following a pattern of decline found in other smoking cessation programs, Dallery said.

For more information, see web link:
University of Florida News November 17, 2009


State Wins $9 Million Grant to Study Smoking Cessation

Health officials in Wisconsin have won a $9 million federal grant to study the best ways to help people stop smoking.

The grant from the National Institutes of Health will recruit 2,300 smokers at a several clinics in south and central Wisconsin, including Aurora Health Care, UW Health, Dean Health System and Mercy Health System.

The study will provide both quit-coaching and nicotine medications.

"We know that most smokers want to quit, but so many struggle with this addiction," Michael Fiore, director of the University of Wisconsin Center for Tobacco Research and Intervention, said in a statement. "This new federal study is designed to meet smokers where they are in terms of their willingness to try quitting."

New figures from the US Centers for Disease Control and Prevention show the number of adults in the US who smoke increased recently to 20.6 percent from 19.8 percent.

The Wisconsin study will begin next spring.

For more information, see web link:
Journal Sentinel November 12, 2009


Switch to 'Light' Cigarettes Makes Quitting Tougher

Experts have long known that "low-tar" and "light" cigarettes aren't any healthier than regular cigarettes, and new research suggests they have another drawback: People who switch to them are less likely to quit, even those who switch specifically because they want to stop smoking.

In fact, "switching to ['light' cigarettes] for any reason is associated with continuing to smoke," said study author Dr. Hilary Tindle, a researcher at the University of Pittsburgh's Division of General Internal Medicine.

However, she acknowledged that the research does not prove that switching leads directly to a lower rate of quitting.

According to the authors, an estimated 84 percent of cigarettes sold in the United States are so-called low-tar and low-nicotine, with many of them called "lights." Some smokers may assume they're healthier than other cigarettes, but medical researchers say smokers still suck in about the same level of carcinogens. And research has shown that "lighter" cigarettes don't reduce smoking-related illness and death.

Regardless of what brand they smoke, "the average smoker dies 13 to 14 years earlier than he or she would die if he or she did not smoke," Tindle said.

In the new study, published online Nov. 3 in the journal Tobacco Control, researchers examined the results of a 2003 survey of 30,800 people in the United States who had smoked within the past year. Thirty-eight percent of them had switched to "lighter" cigarettes, with the largest percentage of those -- 26 percent -- saying they'd done so for better flavor. Forty-three percent mentioned one, two or three reasons for switching, with quitting smoking being one of those reasons.

However, those who had switched were 46 percent less likely to have quit smoking.

Why might switchers be more likely to continue smoking? "Prior research suggests that switching may resolve smokers' cognitive dissonance about smoking -- something along the lines of, 'Well, since I'm smoking a [supposedly] healthier cigarette, I really don't have to worry about lung cancer, heart disease, impotence, wrinkles, early death [fill in the blank] because my health is not at risk,'" Tindle said. "This type of rationale may keep more health-conscious smokers smoking."

But there are other possible explanations, added Robert West, a researcher who studies tobacco use at University College London in England. It's possible, for example, that people who switch are already more dependent on cigarettes and less able to quit, he said.

What to do? "In Europe, tobacco companies are not allowed to call cigarettes low tar or imply that they are in any way safer," West said.

Regardless of how cigarettes are marketed, Tindle said, "the best solution for the problem of how to live longer and healthier is to quit smoking now."

For more information, see web link:
HealthDay November 3, 2009


Entering a New Era in Tobacco Control Research

Update from Dr. Cathy L. Backinger, Chief, Tobacco Control Research Branch, NCI Division of Cancer Control and Population Sciences.

With the enactment of the Family Smoking Prevention and Tobacco Control Act on June 22, the United States entered a new era in tobacco control and prevention. The act, which gives the FDA the authority to regulate tobacco products, means that the tobacco industry will no longer have free reign to market tobacco products to youth, promote so-called “light” cigarettes as less harmful than others, keep scientists and the public in the dark about ingredients and design features of cigarettes, and make unproven health claims for modified tobacco products. Already, the FDA has shown that it intends to act aggressively to implement the new law; on September 22, the agency announced a ban on fruit- and candy-flavored cigarettes.

While the importance of the new law cannot be overstated, it is only one part of a much larger, comprehensive tobacco control and prevention agenda, for which NCI-supported science is critically important. Most recently, NCI funded 15 new grants under two new Requests for Applications (RFAs), jump-starting research in two important areas: improving effectiveness of smoking cessation interventions among low-income adults, and preventing and reducing smokeless tobacco use. In 2010, we expect to fund grants in a third area, targeting state and community tobacco control and media research.

The Nov. 3rd issue of the NCI Cancer Bulletin highlights several important tobacco control research studies supported by NCI. In the largest trial of its kind to date, researchers from the Fred Hutchinson Cancer Research Center found that telephone counseling using motivational interviewing and cognitive behavioral approaches significantly improved 6-month cessation rates in older teens. Given that 20 percent of American high school seniors smoke cigarettes, and that few strategies have been effective at promoting cessation among teen smokers, this finding is very significant. This issue also highlights a study of mobile phone technology provided to DC Tobacco Quitline callers and the expansion of, including new links to social media, such as Facebook, that take advantage of interactive Web technologies to reach new audiences for smoking cessation.

NCI’s tobacco control research cannot be limited to the United States, where, as in most high-income countries, tobacco use is slowly declining. By 2030, global mortality from tobacco use is expected to rise to 8 million deaths per year. About 80 percent of those deaths will occur in low- and middle-income countries, where tobacco use is still increasing. Research will be critical to averting this global epidemic, which threatens to reverse hard-won improvements in global health and which economically developing countries with overburdened health care systems can ill afford.

NCI supports a number of critically important international research projects, including the International Tobacco Control Policy Evaluation Project, which evaluates policies being enacted around the world in response to the World Health Organization’s Framework Convention for Tobacco Control. We are also a co-funder of the Fogarty International Center’s International Tobacco and Health Research and Capacity Building Program, which has galvanized tobacco control research in low- and middle-income countries.

Tobacco use remains the country’s leading cause of premature, preventable death—including an estimated one-third of all cancer deaths—and it is an important contributor to health disparities. But sustained research, comprehensive state-based tobacco control programs, and the FDA’s new authority to regulate tobacco products have put us on the road to a new future. Decades of scientific research supported by NCI and other NIH institutes have provided the foundation for the FDA’s new authority. NCI is committed to working with the FDA and other partners to ensure that scientific research continues to inform and advance tobacco control policies and interventions.

For more information, see web link:
NCI Cancer Bulletin November 3, 2009


Researchers Find Combining Stop-Smoking Medications is Best Bet for Quitting

Researchers at the University of Wisconsin Center for Tobacco Research and Intervention (UW-CTRI) have found that combining an over-the-counter nicotine-replacement patch with the nicotine-replacement lozenge is the best bet for smokers trying to quit. The findings are published in the November issue of the Archives of General Psychiatry, a sister publication to the well-regarded Journal of the American Medical Association. The article details the largest study to date comparing tobacco-dependence treatments head-to-head.

The study compared the following:

  • nicotine patch
  • nicotine lozenge
  • bupropion, a prescription medication
  • nicotine lozenge and patch combined
  • nicotine lozenge and bupropion combined
  • placebo

The study also found that using any of the medications was more effective than using a placebo. “We know that most smokers want to quit. Many have tried,” said Dr. Megan Piper, author of the article in the scientific journal and a researcher at UW-CTRI. “Many of the smokers who try, though, try ‘cold turkey,’ the least effective way to go about it with only a five percent or less success rate. Our findings offer a scientifically validated option. Forty percent of smokers who received the combination of the nicotine patch and the nicotine lozenge were able to achieve long-term abstinence. This treatment provided a two-fold better outcome for quitting success than did the placebo.”

“This is an important study that shows that people may derive greater benefit from a combination of treatments in their efforts to quit smoking,” Dr. Nora Volkow said. She is the director of the National Institute on Drug Abuse, one of the funders of the study along with the National Cancer Institute (NCI). Both are housed within the National Institutes of Health.

“More research is needed to determine whether other therapy combinations can further improve cessation outcomes,” Volkow said.

More than 1,500 Wisconsin smokers participated in the study. They received medication for either eight or 12 weeks along with six sessions of individual counseling.

“This study highlights the importance of providing effective treatment – medication combined with counseling – to all smokers who want to quit,” said Dr. Robert Croyle, director of NCI’s Division of Cancer Control and Population Sciences. “We’ve known for some time that the nicotine patch can help smokers quit, but these new data should encourage smokers to consider using the nicotine lozenge together with the patch to increase their likelihood of success.”

There are seven FDA-approved medications to treat tobacco dependence. The UW-CTRI study tested or examined three of the medications. It did not look nicotine-replacement nasal spray, inhaler or gum. The final FDA-approved medication, varenicline, was not approved at the time the study began. Researchers believe their comparative study design model could next be used to assess further treatment options that are approved by the FDA.

For more information, see web link:
UW-CTRI News Release November 2, 2009


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Other Cessation News

Massachusetts' 'Model' Tobacco Cessation Benefit Spurs Unprecedented Drop in Smoking Rates, Heart Attacks, Asthma, and Birth Complications

A "model" tobacco cessation benefit offered to Massachusetts' Medicaid participants has produced an astounding 26 percent drop in smoking rates in only two and a half years, and has already been linked to decreases in heart attacks, hospitalizations for asthma and COPD, and a significant decrease in birth complications.

Researchers from the Massachusetts Tobacco Cessation and Prevention Program (MTCP) found that up to 38 percent fewer MassHealth cessation benefit users were hospitalized for heart attacks in the first year after using the benefit, and that 18 percent fewer benefit users visited the emergency room for asthma symptoms in the first year after using the benefit. Researchers also found that there were 12 percent fewer claims for adverse maternal birth complications since the benefit was implemented.

The Massachusetts Executive Office of Health and Human Services said more than 75,000 people -- a full 40 percent of MassHealth members who smoke -- have used the benefit to try to quit smoking. Cost savings are being studied, and all indications suggest they will be significant.

"It is clear from these latest findings that the Commonwealth's efforts to help people quit smoking is a sound investment," Executive Office of Health and Human Services Secretary JudyAnn Bigby said. "I have requested that a full analysis of the cost savings reach my desk by June 30, 2010."

Three former US Surgeons General and a national coalition of business, labor, health care professionals and nonprofits have endorsed a nationwide call for action ( to increase access to tobacco cessation benefits for smokers who want to quit. The head of Partnership for Prevention, the disease prevention advocacy organization in Washington, D.C., that organized the national effort, said the Massachusetts experience makes a strong case for expanding cessation benefits.

"As the nation debates the future of its health care system, the national significance of this research cannot be understated," said Robert J. Gould, PhD, President and CEO of Partnership for Prevention, a national organization that advances policies and practices to prevent disease and improve the health of all Americans. "These findings demonstrate that prudent investments in preventive health today will have a dramatic and positive effect on our health care system tomorrow."

MTCP and MassHealth worked together to design a model benefit that includes all FDA-approved medications to quit smoking, behavioral counseling, and features very low co-pays to reduce barriers to access. Beginning in July 2006, MassHealth began providing coverage of smoking cessation as part of the state's health care reform initiative. MTCP promoted the new benefit through radio and transit ads and extensive community outreach. The benefit was introduced into an environment that encourages quitting smoking: Massachusetts has smoke-free workplaces, high cigarette taxes, and a non-smoking social norm, all of which contribute to smokers wanting to quit.

"The significance of this research demonstrates how important it is to provide comprehensive tobacco cessation services to smokers and to make sure they know about them," Department of Public Health Commissioner John Auerbach said. "We know that smokers who get support and use stop-smoking medicines like the patch are more than twice as likely to be able to quit for good as those who try to quit on their own. By introducing these benefits to members of MassHealth and making sure they know about them, we are helping people to break their nicotine addiction."

Smoking remains the number one preventable cause of illness and death in the Commonwealth and in the United States. More than 8,000 Massachusetts residents die annually from the effects of smoking, and tobacco use is associated with $4.3 billion in excess health care costs in Massachusetts each year.

For more information, see web link:
PRNewsWire November 18, 2009


Most Smokers Worldwide Support Workplace Bans: Poll

Even smokers support bans to prohibit lighting up in the workplace, according to a new survey.

The international poll of nearly 5,000 people by research institute RTI International and Harris Interactive showed that nearly three-quarters of workers who smoke and 87 percent of employers support a smoke-free work environment.

"Although there was widespread variations among countries, overall the results demonstrate global support for workplace smoking bans," said Michael Halpern, of RIT who is one of the authors of the report.

"This study shows support for additional programs and policies to increase those bans and assist employees with smoking cessation," he added in a statement.

The strongest support for smoking bans was in India where 85 percent of people voted for smoke-free workplaces, followed by Japan with 75 percent. But only one-third of Germans and 27 percent of Poles thought bans should be in place.

The researchers also found that smokers estimated that they spent about one hour a day puffing on cigarettes, although the majority of people polled did not think the habit had a negative financial impact on the company.

"Several previous studies indicate that despite the beliefs of smoking employees and some employers in our study, smoking does have a substantial negative impact on a business's finance," Halpern added.

The World Health Organization (WHO) has been a champion of a global ban on smoking at work. Many countries, including France, Spain, Ireland and Portugal have introduced bans to prevent workplace smoking.

Smoking is a leading cause of preventable death. The WHO says some 200,000 workers die each year due to exposure to smoke at work, while around 700 million children, around half the world's total, breathe air polluted by tobacco smoke, particularly in the home.

According to the WHO almost one billion men and 250 women worldwide smoke some form of tobacco.

South Korea, Japan, China, Taiwan, India, Britain, Italy, Sweden, France, Germany, Spain, Poland, Turkey and Brazil participated in the poll which involved 3,500 workers, smokers and non-smokers, and more than 1,400 employers in the 14 countries.

For more information, see web link:
ABC News November 17, 2009


National Stop Smoking Campaign Continues With Information, Resources for Smokers

With the latest research estimating that nearly six million people worldwide will lose their lives to tobacco next year, an innovative approach is critical to helping the 43 million Americans who smoke to finally quit. This month, which is observed as Lung Cancer Awareness Month, the national quit smoking program, EX(R) will debut the second phase of advertising and promotions designed to help smokers "re-learn" life without cigarettes.

The campaign will begin airing this month on radio and cable television networks as well as online, in print and through ambient/out-of-home channels. EX is a national quit smoking campaign, sponsored by the National Alliance for Tobacco Cessation (NATC), a two-year old collaborative of state and national public health groups spearheaded by Legacy(SM), creators of the award-winning truth(R) youth smoking prevention campaign.

EX is more than an advertising campaign, it provides evidence-based tools to help smokers quit, including information that can help them prepare for a quit attempt by 1) "Re-learning" their thinking on the behavioral aspects of smoking and how different smoking triggers can be overcome with practice and preparation; 2) "Re-learning" their knowledge of addiction and how medications can increase their chances for quitting success; and 3) "Re-learning" their ideas of how support from friends and family members can play a critical role in quitting.

Because social support is so important, EX has used a state-of-the-art Web site ( as a convening point for smokers who want to quit and collaborate on their successes and challenges in the difficult quit process. Since March 2008, when the program first debuted, over a million people have visited the site and more than 14,000 smokers have joined the online community, forming nearly 300 customized support groups. EX tools were designed in collaboration with Mayo Clinic and with input from former and current smokers who have lived with this struggle, in order to provide smokers with a realistic approach based on evidence-based research.

For the 2009 edition of the campaign, a major focus of the placements will be through partnerships with Major League Baseball on Fox, "Bassmasters" on ESPN2 and on radio through ABC and Sporting News Radio. The campaign will run from mid-Fall (November 1) through January, hopefully encouraging smokers to prepare to quit as their New Year's Resolution.

Descriptions of television spots:

Many smokers light up when they drive. At the beginning of "Spin," a man leaves his store for a smoke break. Cigarette in hand, he tries the doors of a few cars, before jumping into an idling delivery van and driving off. The voice over relates: "You don't drive every time you smoke; yet, you smoke every time you drive" and exhorts the viewer to "relearn life without cigarettes" at

"Receptionist" is a look at the habit many people have of smoking while drinking alcohol. Cigarettes at the ready, a woman at her desk in an office setting crushes ice, chops strawberries and then blends the mixture while her coworkers all try to work. As she heads outside with her margarita, the voice over explains "You don't drink every time you smoke; yet, you smoke every time you drink" and offers that the viewer can "relearn life without cigarettes" at

For more information, see web link:
PRNewsWire November 9, 2009


Reynolds Is in Talks to Buy Maker of Smoking-Cessation Products

Reynolds American Inc., maker of Camel cigarettes and Grizzly smokeless tobacco, is in talks to buy a Swedish company that helps people stop smoking, a tobacco expert who said he was briefed by people close to the talks told The Associated Press.

The second-largest US tobacco company is eyeing Niconovum AB, which sells cigarette replacement products in gum, pouch and spray form outside the US, according to David Sweanor, a Canadian law professor and tobacco expert.

The deal, which could be worth $44.5 million, could be imminent, he said.

Sweanor said Reynolds' interest in Niconovum may be focused on offering smoking alternatives rather than products meant to help people stop using nicotine and tobacco.

"The market's coming to understand that nicotine products exist on a very broad continuum of risk, and cigarettes are at the far risky end of that, and it's possible to have far less hazardous products that would probably meet the needs for a very significant number of smokers," Sweanor said.

The possibility of a deal between Reynolds and Niconovum was first reported by the Wall Street Journal.

Karl Olov Fagerstrom, an expert on smoking cessation and nicotine dependence, formed Niconovum in 2000, according to its Web site. Niconovum did not immediately return calls seeking comment.

Reynolds American spokesman David Howard declined to comment.

Reynolds, like all tobacco companies, is looking to cigarette alternatives such as smokeless tobacco for growth as demand for cigarettes has declined as taxes, health concerns, smoking bans and social stigma have increased.

The company, based in Winston-Salem, N.C., has introduced Camel brand moist, smokeless tobacco and snus - small teabag-like pouches that users stick between the cheek and gum. It also has introduced dissolvable tobacco products - finely milled tobacco shaped into orbs, sticks and strips - in test markets.

For more information, see web link:
CBS News November 9, 2009


Insurers Step up to Save Colorado Anti-Smoking Program

Five of the state’s top private insurers have agreed to a deal that would save QuitLine — a state-sponsored smoking-cessation program — from massive cuts.

The agreement will let QuitLine continue to serve Coloradans with insurance coverage.

The insurers — Aetna, Kaiser Permanente, Humana, Cigna and Rocky Mountain Health Plans — all agreed to pay QuitLine to provide smoking-cessation services for members covered by their plans.

Two other large Colorado insurers — Anthem Blue Cross and Blue Shield of Colorado and UnitedHealthcare — remain undecided on the public-private partnership. Insurers were given until Oct. 31 to get onboard with the deal.

QuitLine’s funding depended on a measure approved by Colorado voters in 2004. The measure, Amendment 35, retained a sales tax on tobacco products to fund health initiatives in the state.

The program is overseen by the State Tobacco and Partnership Program (or STEPP), whose $26 million budget was cut by $15 million after Colorado lawmakers approved a bill that let officials transfer revenue from state tobacco sales to cover recession-driven shortfalls in the state’s budget.

STEPP already faced shrinking revenue because funds from tobacco sales are decreasing as fewer people smoke. QuitLine’s budget was cut by nearly 40 percent — leaving the program with a $2.9 million budget for the fiscal year.

The cuts meant QuitLine would have been able to only serve uninsured people, pregnant women (regardless of insurance coverage) and Medicaid recipients, said Deb Osborne, STEPP’s director of cessation initiatives.

But Osborne said that a public-private partnership between QuitLine and the insurers made sense in light of a new mandate that requires insurers to cover the cost of preventative health services.

Earlier this year, legislators and Colorado Gov. Bill Ritter approved House Bill 1204, which requires health insurers to provide fully insured members with preventative health services, including tobacco-cessation programs.

Prior to the passage of HB 1204, Osborne said Kaiser Permanente and Humana already offered smoking cessation as a benefit for all members with the rationale that the benefit pays for itself by reducing the rate of smoking-related health problems.

Since most insurers don’t offer their own smoking-cessation program, QuitLine is offering its program as a service they pay for, Osborne said.

QuitLine’s nicotine-replacement therapy costs the state roughly $57 per enrollee — a discounted rate compared to other cessation programs, Osborne said. She added that roughly a third of QuitLine participants have private health insurance coverage, another third have no insurance, and the remainder are covered by government-sponsored health insurance plans like Medicaid.

Osborne notes that Colorado doctors often refer their patients who smoke to QuitLine. She said the brand recognition also will serve insurers well since smokers know how to seek the service through its well-advertised, toll-free hotline.

Matt Keelin, director of health initiatives for National Jewish Health, which is commissioned by the state to run QuitLine, said 185,000 people have gone through the program since 2002 when it was founded. Keelin said that’s a good track record considering smoking is regarded as one of the toughest addictions to overcome. National Jewish employs 38 people for its Colorado QuitLine program.

For more information, see web link:
Denver Business Journal November 4, 2009


Groups Launch Effort to Promote Smoking Cessation Among American Indians

The University of Kansas Medical Center has helped develop a program aimed at reducing smoking rates among residents of Native American Indian reservations, Indian Country Today reports. Created as part of a partnership between the hospital and the American Lung Association, the All Nations Breath of Life program provides free smoking cessation assistance to Native Americans and provides them the opportunity to learn and explain the importance of sacred tobacco to their respective nations.

As part of the program, which typically lasts approximately eight weeks, fellow American Indians lead discussions with participants on various smoking cessation topics, such as use of tobacco, facts about smoking, how to quit, dealing with withdrawal and cravings, traditional tobacco use, support from family, and preventing relapse. Participants then spend three weeks away from the group participants and return for a group session at the 12-week mark. After three months, participants return again for a final group session. Throughout the program, participants have access to telephone counseling services.

To date, the program has worked with approximately 220 tribes in both urban and reservation communities in the greater Kansas City area, as well in Oklahoma, California and Minnesota. The program has funding to continue for four years and is also exploring the possibility of developing a telemedicine version of the program.

For more information, see web link:
RWJF Public Health Digest November 3, 2009


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